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   Author  Topic: What is Hemicrania Continua?  (Read 172 times)
Sean_C
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What is Hemicrania Continua?
« on: May 27th, 2005, 9:32pm »
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What is Hemicrania Continua?  
 
Hemicrania continua is a rare form of chronic headache marked by continuous pain on one side of the face that varies in severity. Superimposed on the continuous but fluctuating pain are occasional attacks of more severe pain. Symptoms fall into two main categories: autonomic, including runny nose, tearing, eye redness, eye discomfort, sweating, and swollen and drooping eyelids; and migraine-like, including nausea, vomiting, and sensitivity to light and sound. The disorder has two forms: continuous, with daily headaches, and remitting, where headaches may occur for as long as 6 months and are followed by a pain-free period of weeks to months until they recur. Most patients experience attacks of increased pain three to five times per 24-hour cycle. This disorder is more common in women than in men. Physical exertion and alcohol use may increase the severity of headache pain in some patients. The cause of this disorder is unknown.  
 
Sounds familiar doesn't it. For all of you that can nap during a cluster PF days are around the corner.  
 
http://www.ninds.nih.gov/disorders/hemicrania_continua/hemicrania_contin ua.htm#What_is
 
Sean...................................
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Re: What is Hemicrania Continua?
« Reply #1 on: May 28th, 2005, 7:13am »
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I was wondering as to where you found information that a diagnostic criteria of HC is sleeping during an attack?  According to my research, an HC "attack" can be nearly as severe as CH, and I wouldn't think one would necessarily be able to nap during that sort of pain, from either disorder.
 
Hemicrania Continua used to be classified in the International Classification of Headache Disorders as a group 3 Trigeminal Autonomic Cephalalgia, the same group as Cluster Headache, and still maintains a close relationship to that group, but the 2nd edition now lists it as a group 4 Other Primary Headache.  The diagnosis criteria is somewhat similar to CH, except for a moderate, daily, continuous headache, as well as occasional exacerbations of severe pain or "attacks".  The diagnosis criteria does require that the pain respond to indomethacin, but there has been reports of refractive HC being diagnosed.  Below is the diagnostic criteria guidelines listed by the IHS:
 
4.7 Hemicrania continua
 
Description:
 
Persistent strictly unilateral headache responsive to indomethacin.
 
Diagnostic criteria:
 
A. Headache for >3 months fulfilling criteria B–D
B. All of the following characteristics:
  1. unilateral pain without side-shift
  2. daily and continuous, without pain-free periods
  3. moderate intensity, but with exacerbations of severe pain
C. At least one of the following autonomic features occurs during exacerbations and ipsilateral to the side of pain:
  1. conjunctival injection and/or lacrimation
  2. nasal congestion and/or rhinorrhoea
  3. ptosis and/or miosis
D. Complete response to therapeutic doses of indomethacin
E. Not attributed to another disorder1
 
Note:
 
1. History and physical and neurological examinations do not suggest any of the disorders listed in groups 5–12, or history and/or physical and/or neurological examinations do suggest such disorder but it is ruled out by appropriate investigations, or such disorder is present but headache does not occur for the first time in close temporal relation to the disorder.
 
Comment:
Hemicrania continua is usually unremitting, but rare cases of remission are reported. Whether this headache type can be subdivided according to length of history and persistence is yet to be determined.
 
PFDAN............................... Drk^Angel
 
P.S.  This information should not be used to recommend diagnosis or treatment.  Anyone who feels that they may be misdiagnosed should talk with a qualified doctor.
 
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